Southeast Psychological Services, Pllc | |
6060 Piedmont Row Dr S Suite 120 Charlotte NC 28287-3884 | |
(704) 552-0116 | |
(704) 552-7550 |
Full Name | Southeast Psychological Services, Pllc |
---|---|
Speciality | Psychologist |
Location | 6060 Piedmont Row Dr S, Charlotte, North Carolina |
Authorized Official Name and Position | Frank W Gaskill (MANAGING PARTNER) |
Authorized Official Contact | 7045520116 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Southeast Psychological Services, Pllc 6060 Piedmont Row Dr S Suite 120 Charlotte NC 28287-3884 Ph: (704) 552-0116 | Southeast Psychological Services, Pllc 6060 Piedmont Row Dr S Suite 120 Charlotte NC 28287-3884 Ph: (704) 552-0116 |
NPI Number | 1811053218 |
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Provider Enumeration Date | 12/29/2006 |
Last Update Date | 11/25/2014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1811053218 | NPI | - | NPPES |
6005111 | Medicaid | NC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103T00000X | Psychologist | CO5021 (North Carolina) | Secondary |
103T00000X | Psychologist | (* (Not Available)) | Primary |
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